ПРОЕКТ “ARIA”: ШЛЯХИ НАДАННЯ МЕДИЧНОЇ ДОПОМОГИ ПРИ АЛЕРГІЧНОМУ РИНІТІ (2019 РІК) – УКРАЇНА

In all societies, the burden and cost of allergic diseases are increasing rapidly, and change management strategies are needed to support the transformation of the health care system for integrated care. A meeting was held in Paris, December 3, 2018 for chronic disease care. It was organised by MASK (Mobile Airways Sentinel NetworK) and POLLAR (Impact of Air Pollution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases. The evaluation of real-life Integrated Care Pathways (ICPs) was recommended fordigitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity embedding environmental exposure. ICPs are structured multi-disciplinary care plans detailing key steps of patient care. They promote the translation of guideline recommendations into local protocols and their application to clinical practice. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology explicitly considers all types of study designs but guideline developers often prefer to restrict guidelines to RCTs. GRADE also considers evidence about values and preferences, acceptability and feasibility or directness of findings. There is an increasing trend to use real-world evidence (RWE) to inform clinical practice. AIRWAYS ICPs (Integrated care pathways for airway diseases) were the first steps towards the development of ICPs for rhinitis and asthma multimorbidity. During the Paris meeting, next-generation guidelines for the pharmacologic treatment of AR were developed using existing GRADE-based guidelines for AR tested using RWE provided by mobile technology and chamber studies. These recommendations were used to refine the MASK algorithm for AR treatment proposed by a consensus group. In allergic rhinitis (AR), there is an urgent need to develop next-generation guidelines for pharmacotherapy and ICPs for allergen immunotherapy (AIT). Two separate documents were produced following the Paris meeting. This paper clarifies the ways of implementing this direction in Ukraine.

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Integrated Care Pathways for Airway Diseases

The Lancet Respiratory Medicine ◽

10.1016/s2213-2600(16)00004-7 ◽

2016 ◽

Vol 4 (2) ◽

pp. 106

Author(s):

Diana Stanley

Keyword(s):

Integrated Care ◽

Care Pathways ◽

Airway Diseases ◽

Integrated Care Pathways

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Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Clinical and Translational Allergy ◽

10.1186/s13601-019-0279-2 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 15

Author(s):

J. Jean Bousquet ◽

◽

Holger J. Schünemann ◽

Alkis Togias ◽

Marina Erhola ◽

...

Keyword(s):

Health Care ◽

Health Literacy ◽

Respiratory Diseases ◽

Good Practice ◽

Real Life ◽

Digital Transformation ◽

Care Pathways ◽

Main Body ◽

Next Generation ◽

Sentinel Network

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

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Integrated care pathways for airway diseases (AIRWAYS-ICPs)

European Respiratory Journal ◽

10.1183/09031936.00014614 ◽

2014 ◽

Vol 44 (2) ◽

pp. 304-323 ◽

Cited By ~ 112

Author(s):

J. Bousquet ◽

A. Addis ◽

I. Adcock ◽

I. Agache ◽

A. Agusti ◽

...

Keyword(s):

Integrated Care ◽

Care Pathways ◽

Airway Diseases ◽

Airways Icps ◽

Integrated Care Pathways

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INTEGRATED CARE PATHWAYS IN LUNG CANCER: A QUALITY IMPROVEMENT PROJECT

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646231700441x ◽

2018 ◽

Vol 34 (1) ◽

pp. 3-9 ◽

Cited By ~ 1

Author(s):

Gianpiero Fasola ◽

Jessica Menis ◽

Alessandro Follador ◽

Elisa De Carlo ◽

Francesca Valent ◽

...

Keyword(s):

Lung Cancer ◽

Quality Improvement ◽

Integrated Care ◽

Real Life ◽

University Hospital ◽

Care Pathways ◽

Improvement Project ◽

Managerial Skills ◽

Integrated Care Pathways ◽

Nsclc Patients

Background:Non small cell lung cancer (NSCLC) diagnosis and treatment is a highly complex process, requiring managerial skills merged with clinical knowledge and experience. Integrated care pathways (ICPs) might be a good strategy to overview and improve patient's management. The aim of this study was to review the ICPs of NSCLC patients in a University Hospital and to identify areas of quality improvement.Materials and Methods:The electronic medical records of 169 NSCLC patients visited at the University Hospital were retrospectively reviewed. Quality of care (QoC) has been measured trough fifteen indicators, selected according main international Guidelines and approved by the multi-disciplinary team for thoracic malignancies. Results have been compared with those of a similar retrospective study conducted at the same hospital in 2008.Results:A total of 146 patients were considered eligible. Eight of fifteen indicators were not in line with the benchmarks. We compared the results obtained in the two separate periods. Moreover, we process some proposal to be discussed with the general management of the hospital, aimed to redesign NSCLC care pathways.Conclusions:ICPs confirm to be feasible and to be an effective tool in real life. The periodic measurement of QoC indicators is necessary to ensure clinical governance of patients pathways.

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ARIA guideline 2019: treatment of allergic rhinitis in the German health system

Allergo Journal International ◽

10.1007/s40629-019-00110-9 ◽

2019 ◽

Vol 28 (7) ◽

pp. 255-276 ◽

Cited By ~ 1

Author(s):

Ludger Klimek ◽

Claus Bachert ◽

Oliver Pfaar ◽

Sven Becker ◽

Thomas Bieber ◽

...

Keyword(s):

Allergic Rhinitis ◽

Health System ◽

Integrated Care ◽

Respiratory Diseases ◽

Social Systems ◽

Real Life ◽

Care Pathways ◽

Chronic Respiratory Diseases ◽

Number Of Patients ◽

Integrated Care Pathways

Abstract Background The number of patients affected by allergies is increasing worldwide. The resulting allergic diseases are leading to significant costs for health care and social systems. Integrated care pathways are needed to enable comprehensive care within the national health systems. The ARIA (Allergic Rhinitis and its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. Methods ARIA serves to improve the care of patients with allergies and chronic respiratory diseases. In collaboration with other international initiatives, national associations and patient organizations in the field of allergies and respiratory diseases, real-life integrated care pathways have been developed for a digitally assisted, integrative, individualized treatment of allergic rhinitis (AR) with comorbid asthma. In the present work, these integrated care pathways have been adapted to the German situation and health system. Results The present ICP (integrated care pathways) guideline covers key areas of the care of AR patients with and without asthma. It includes the views of patients and other healthcare providers. Discussion A comprehensive ICP guideline can reflect real-life care better than traditional guideline models.

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